A team of scientists employing a sophisticated computer model pioneered at Princeton University and Resources for the Future has found that many governments worldwide are recommending the wrong kind of malaria treatment.
Despite the availability of many drugs and therapies to treat malaria, many countries' national policies recommend using what is known as a single first-line therapy -- that is, using one drug repeatedly with many patients. Writing in the Sept. 16 issue of the Proceedings of the National Academy of Sciences, a team led by Maciej Boni, who conducted the research as a postdoctoral fellow at Princeton and scholar at Resources, a Washington, D.C.-based think tank, reports that countries could cut the death rate and forestall the development of drug resistance if a variety of different drugs were distributed to patients.
This approach, known as multiple first-line therapies or MFT, could be put into place by making sure different drugs cost about the same, so that patients would not be forced into buying the cheapest available drug but would choose from a random pool. Or it could be applied by clinic physicians who could simply alternate their choices for drugs they prescribe to patients.
"What we found is that using multiple first-line therapies is the best way to avoid treatment failures and to delay the development of resistance for as long as possible," said Boni, who recently has joined the staff of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam.
One catch to the researchers' strategy is that multiple effective therapies may not always be available. In some African countries where drug-resistance is already widespread, the only effective therapies are a class of drugs known as artemisinin-based combination therapies (ACTs).
"MFT does not necessarily solve all our problems," said Boni. "Antimalarial drug development needs to continue with the hope of producing novel
|Contact: Kitta MacPherson|